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DE/ARTM[!IT OF COMMUNITY DEVEIO�MEh� SERVICES <br />BUILDING PERMIT INFORMATION <br />ADDRESS TYPE <br />(1) BUILDING PERMIT FEE � <br />(A) PL�1N CHECK FEE <br />(2) PLUMBING <br />(3) MECHANICAL <br />(4) WATER SERVICE TO BE PAID PRIOR TO BUILDING PERMIT ISSUANCE <br />(A) TO BE DETERMINED BY BLDG INSPECTOR INCH <br />(B) EXIST. WATER SERVICE, APPLICATION NO. <br />(C) APPROX. LOCATION <br />CHART - <br />(5) DRIVEWAY PERMIT TO BE PAID PRIOR TO BUILDING PERMIT IS- <br />SUANCE FEEi DRIVEWAY(TYPE) S <br />b <br />(7) STATUS OF SEWER CHARGES: <br />BUND DISTRICT <br />NOTES <br />FOOTAGE <br />N, 5, E, W <br />SEWER CONNECTION CHARGES <br />YEAR TRUNK <br />LATERAL <br />TOTAL CONNECTION CHARGES <br />SEWER PERMIT FEE <br />CATCH BASIN PERMIT FEE <br />TOTAL SEWER PERMIT FEES <br />(7) MONTHLY SEWER CHARGES: <br />SEWER CONSTRUCTION <br />� <br />3 <br />�' <br />b <br />TRUCK s <br />LATERAL <br />SEWER SERVICE <br />APPROX. LOCATIO,V OF SIDE SEWER OR TEE IN THE MAIN: <br />INFO COMPILED BY: <br />APPROVAL: <br />91 79 <br />5.�n <br />CHART <br />DATE <br />DATE <br />� <br />